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Table 2 Summary of eight cost-effectiveness studies

From: Systematic review of cost and cost-effectiveness of different TB-screening strategies

  Study period Country Study population Outcome Strategies Results
Pooran et al. [21] 2 years UK Close contacts Incremental costs/active TB case prevented TST-only
T-SPOT.TB-only
TST+T-SPOT
QFT-only
TST+QFT
₤ 47,840
₤ 39,712
₤ 37,206
₤ 42,051
₤ 37,699
Marra et al. [22] 20 years,
3% discounted
Canada Close contacts
of foreign-born,
non-aboriginal Canadian-born and aboriginal TB cases
Incremental costs/QALY QFT (BCG+) + TST (BCG-)
TST+QFT (BCG+) +TST (BCG-)
QFT (foreign-born, aboriginal, BCG+) +TST (BCG-)
QFT (foreign-born and aboriginal) + TST (others)
TST+QFT (foreign-born, aboriginal, BCG+) +TST (others)
TST+QFT (foreign-born, ab-original) + TST (others)
TST+QFT (all)
QFT (all)
Dominant
Dominant
CAD 31,930
CAD 40,433
CAD 135,672
Dominated
Dominated
CAD 79,443
Oxlade et al. [23] 20 years,
3% discounted
Canada Close and casual contacts Incremental costs/case prevented No screening
TST
QFT
TST+QFT
TST cost saving in close contacts (and casual contacts from low incidence countries) with exception of contacts receiving BCG after infancy (cost savings for QFT)
    Immigrants Incremental costs/case prevented No screening
CXR only
TST only
QFT only
TST+QFT
least expensive for subjects from high and intermediate incidence countries: CAD 875-30,680
Less expensive than QFT: CAD 46,600 (high incidence) -800,000 (intermediate)
Most expensive: CAD 62, 643 (high incidence) 75, 777 (intermediate)
Least expensive for subjects from low inci-dence countries): CAD 27,369-45,827
Kowada et al.[24] Lifetime,
3% discounted
Japan Close contacts Incremental costs/QALY IGRA-only
TST-only
TST+IGRA
$ 471.54
$ 573.98, dominated by IGRA-only
$ 500.55, dominated by IGRA-only
de Perio et al. [25] Lifetime,
3% discounted
USA HCWs with
no BCG vaccination
Incremental costs/QALY QFT-IT
QFT-G
TST
Not assessed
$ 14,092
Dominated
    HCWs with
BCG vaccination
  QFT-IT
QFT-G
TST
Not assessed
$ 103,047
Dominated
Deuffic-Burban et al. [26] Lifetime,
3% discounted
France Close contacts Incremental costs/LYG No screening
TST ≥ 10 mm +QFT
QFT
TST ≥ 5 mm
€ 560
€ 730
Strongly dominated
      TST ≥ 5 mm +QFT
TST ≥ 10 mm
Weakly dominated
Strongly dominated
Diel et al. 2007 [27] 20 years
3% discounted
Germany Close contacts Incremental costs/LYG No treatment
TST > 5
TST > 10
QFT
TST+QFT
$ 30,170
dominant
dominant
dominant
Diel et al. [28] 20 years,
3% discounted
Switzerland Close contacts in
middle-aged group
Incremental costs/LYG TST > 5 mm
TST > 10 mm
TST > 15 mm
T-SPOT-only
TST+T-SPOT
€ 141,502
€ 107,151
€ 44,831
€ 23,692
€ 23,692
    Young group Incremental costs/LYG TST > 5 mm
TST > 10 mm
TST > 15 mm
T-SPOT-only
TST+T-SPOT
€ 96,705
€ 70,955
€ 26,451
€ 11,621
€ 11,621